山东省糖尿病患者治疗依从性影响因素的定性分析

Qualitative Analysis of Factors Influencing DM2 Patient Treatment Compliance in Shandong Province

目的:从卫生体系的角度系统分析影响糖尿病患者治疗依从性的因素,并提出改善建议。方法:采用焦点小组讨论法收集资料,运用Nvivo11及主题框架法进行定性资料的编码和分析。结果:影响糖尿病患者治疗依从性的因素包括:患者的知识水平较低、健康意识薄弱、生活习惯和经济状况较差;卫生服务提供者的知识技能缺乏、糖尿病管理服务不足以及各机构间合作欠缺;基本药物的限制和不完善的医疗保险报销政策。结论:社区糖尿病管理应更加重视卫生系统中关键要素的调整,通过改善服务的连续性和协调性来提高糖尿病患者的治疗依从性。

Objective:To analyze the factors influencing the treatment compliance of DM2 patient from the perspectives of community health care providers and to give some suggestions on improving the performance of community-based diabetes management.Methods:Eight focus group interviews were used for data collection,and we use the Nvivo11 and thematic framework analysis to code and analyze qualitative data.Results:The factors affecting the treatment compliance of T2DM patients were categorized into patient-related factors,provider-related factors and health system-related factors.Patient-related factors included insufficient knowledge,bad health awareness and life habits and poor economic status of patients.Provider-related factors included the lack of knowledge and skills,insufficient provision of diabetes management services and poor service coordination between providers.Health system-related factors included basic drug use restriction and incorrect reimbursement of health insurance.Conclusion:Community-based diabetes management should pay more attention to adjustment of the key elements in health system which may be useful for improving the continuity and coordination of service.